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Serati L, Mardigyan V, Dominioni CC, Agozzino F, Bizzi E, Trotta L, Nivuori M, Maestroni S, Negro E, Imazio M, Brucato A. Pericardial Diseases in Pregnancy. Can J Cardiol 2023; 39:1067-1077. [PMID: 37086835 DOI: 10.1016/j.cjca.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023] Open
Abstract
Pericardial effusion is the most common manifestation of pericardial diseases during pregnancy. This effusion is benign, mild, or moderate, well tolerated, with spontaneous resolution after delivery; no specific treatment is required. Acute pericarditis is the second most common condition, usually requiring medical therapy during pregnancy. Cardiac tamponade and constrictive pericarditis are rare in pregnancy. Pre-pregnancy counselling is essential in women of childbearing age with recurrent pericarditis to plan pregnancy in a phase of disease quiescence and to review therapy. High-dose aspirin or nonselective nonsteroidal anti-inflammatory drugs, such as ibuprofen and indomethacin, can be used up to the 20th week of gestation. Low-dose prednisone (2.5-10 mg/d) can be administered throughout pregnancy. All of these medications, apart from high-dose aspirin, may be used during lactation. Colchicine is compatible with pregnancy and breastfeeding, and it can be continued throughout pregnancy to prevent recurrences. Appropriate follow-up with a multidisciplinary team with experience in the field is recommended throughout pregnancy to ensure good maternal and fetal outcomes.
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Affiliation(s)
- Lisa Serati
- Department of Internal Medicine, Fatebenefratelli Hospital, Milan, Italy.
| | - Vartan Mardigyan
- Department of Medicine, Jewish General Hospital, Montréal, Québec, Canada
| | | | - Francesco Agozzino
- Department of Internal Medicine, Fatebenefratelli Hospital, Milan, Italy
| | - Emanuele Bizzi
- Department of Internal Medicine, Fatebenefratelli Hospital, Milan, Italy
| | - Lucia Trotta
- Department of Internal Medicine, Fatebenefratelli Hospital, Milan, Italy
| | - Mariangela Nivuori
- Department of Internal Medicine, Fatebenefratelli Hospital, Milan, Italy
| | - Silvia Maestroni
- Department of Internal Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Enrica Negro
- Department of Internal Medicine, Fatebenefratelli Hospital, Milan, Italy
| | - Massimo Imazio
- Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia," Udine, Italy
| | - Antonio Brucato
- Department of Biomedical and Clinical Sciences, University of Milan, Fatebenefratelli Hospital, Milan, Italy
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Tsushima T, Ishii N, Matsuzaka S, Armitage K, Ohkusu K, Cammack I, Yamada A, Mori Y, Sasaki S, Hayashi K, Serizawa Y. Culture-negative group B streptococcal pericarditis: A case report and literature review of the diagnostic use of polymerase chain reaction. Clin Case Rep 2019; 7:509-514. [PMID: 30899483 PMCID: PMC6406155 DOI: 10.1002/ccr3.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/12/2018] [Accepted: 01/04/2019] [Indexed: 12/04/2022] Open
Abstract
Although conventional microbiology cultures may be negative, polymerase chain reaction (PCR) can effectively identify both typical and atypical microorganisms. With careful interpretation, PCR could become the gold-standard diagnostic test for culture-negative bacterial pericarditis.
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Affiliation(s)
- Takahiro Tsushima
- Department of MedicineUniversity Hospitals Cleveland Medical CenterClevelandOhio
| | - Natsuko Ishii
- Division of CardiologyTeine Keijinkai HospitalSapporoJapan
| | - Suguru Matsuzaka
- Department of General Internal MedicineTeine Keijinkai HospitalSapporoJapan
| | - Keith Armitage
- Division of Infectious Diseases and HIV Medicine, Department of MedicineUniversity Hospitals Cleveland Medical CenterClevelandOhio
| | - Kiyofumi Ohkusu
- Department of MicrobiologyTokyo Medical UniversityTokyoJapan
| | - Ivor Cammack
- Department of General Internal MedicineTeine Keijinkai HospitalSapporoJapan
| | - Akira Yamada
- Division of Cardiac SurgeryTeine Keijinkai HospitalSapporoJapan
| | - Yuichiro Mori
- Division of CardiologyTeine Keijinkai HospitalSapporoJapan
| | | | | | - Yoshimoto Serizawa
- Department of General Internal MedicineTeine Keijinkai HospitalSapporoJapan
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